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ORIGINAL ARTICLE
Year : 2017  |  Volume : 44  |  Issue : 3  |  Page : 111-117

Evaluation of disease activity markers in relation to dry eye disease in patients with rheumatoid arthritis


1 Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Internal Medicine, Allergy and Immunology, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
3 Department of Ophthalmology, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
4 Department of Clinical Pathology, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Mohja A El-Badawy
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, 211 Abdel-Hamid Keshk Street, Hadaeq EL-Quba, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-161X.212040

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Purpose The aim of this study was to correlate the presence of anti-cyclic citrullinated peptide (anti-CCP) and anti-mutated citrullinated vimentin (anti-MCV) antibodies with rheumatoid disease activity and dry eye disease in patients with rheumatoid arthritis (RA). Patients and methods A total of 69 patients were evaluated for the activity of RA using the Disease Activity Score (DAS-28), erythrocyte sedimentation rate, and C-reactive protein. We used the Health Assessment Questionnaire-Disability Index to assess functional disability. Anti-CCP and anti-MCV antibodies were measured using enzyme-linked immunosorbent assay technique. We assessed dry eye symptoms using Ocular Surface Disease Index (OSDI) questionnaire. Clinical tests used for dry eye assessment included Schirmer’s test, tear breakup time test, and ocular surface fluorescein staining. Results Anti-CCP antibody serum levels significantly correlated with DAS (r=0.46, P=0.036), Schirmer’s test (r=0.40, P=0.038), and ocular surface fluorescein staining (r=0.6, P=0.04). Anti-MCV antibody serum levels correlated with DAS (r=0.5, P=0.04), ocular surface fluorescein staining (r=0.9, P=0.007), and OSDI score (r=0.3, P=0.03). DAS showed a nonsignificant correlation with OSDI score and all tests of dry eye. OSDI score significantly correlated with Schirmer’s test (P=0.036). Conclusion Dry eye is the most common ocular manifestation in our investigated patients with RA. Dry eye disease existence is not correlated with disease activity, hence all patients with RA should be regularly examined for dye eye regardless of disease severity. Rheumatologists could use the OSDI questionnaire for screening dry eye disease in patients with RA. The presence of anti-CCP and anti-MCV antibodies may denote the existence of dry eye disease and correlates with RA disease activity.


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